Provider Demographics
NPI:1376008672
Name:FIELDS, PAMELA N (FNP -BC)
Entity Type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:N
Last Name:FIELDS
Suffix:
Gender:F
Credentials:FNP -BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 CAMBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-9278
Mailing Address - Country:US
Mailing Address - Phone:504-453-3944
Mailing Address - Fax:
Practice Address - Street 1:43 CAMBRIDGE CIR
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-9278
Practice Address - Country:US
Practice Address - Phone:504-453-3944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-31
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA122384163WG0000X
LA203821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice